scholarly journals Anterior cervical corpectomy and fusion with stand-alone cages in patients with multilevel degenerative cervical spine disease is safe

2022 ◽  
Vol 23 (1) ◽  
Author(s):  
Mohamed H. Tohamy ◽  
Georg Osterhoff ◽  
Ahmed Shawky Abdelgawaad ◽  
Ali Ezzati ◽  
Christoph-E. Heyde
Keyword(s):  
Cervical Spine ◽  
Vertebral Body ◽  
Significant Loss ◽  
Cervical Corpectomy ◽  
Anterior Plating ◽  
Degenerative Cervical Spine ◽  
Anterior Cervical Corpectomy ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

Abstract Background In case of spinal cord compression behind the vertebral body, anterior cervical corpectomy and fusion (ACCF) proves to be a more feasible approach than cervical discectomy. The next step was the placement of an expandable titanium interbody in order to restore the vertebral height. The need for additional anterior plating with ACCF has been debatable and such technique has been evaluated by very few studies. The objective of the study is to evaluate radiographic and clinical outcomes in patients with multilevel degenerative cervical spine disease treated by stand-alone cages for anterior cervical corpectomy and fusion (ACCF). Methods Thirty-one patients (66.5 ± 9.75 years, range 53–85 years) were analyzed. Visual Analog Scale (VAS) and the 10-item Neck Disability Index (NDI) were assessed preoperatively and during follow-up on a regular basis after surgery and after one year at least. Assessment of radiographic fusion, subsidence, and lordosis measurement of Global cervical lordosis (GCL); fusion site lordosis (FSL); the anterior interbody space height (ant. DSH); the posterior interbody space height (post. DSH); the distance of the cage to the posterior wall of the vertebral body (CD) were done retrospectively. Mean clinical and radiographic follow-up was 20.0 ± 4.39 months. Results VAS-neck (p = 0.001) and VAS-arm (p < 0.001) improved from preoperatively to postoperatively. The NDI improved at the final follow-up (p < 0.001). Neither significant subsidence of the cages nor significant loss of lordotic correction were seen. All patients showed a radiographic union of the surgically addressed segments at the last follow up. Conclusions Application of a stand-alone expandable cage in the cervical spine after one or two-level ACCF without additional posterior fixation or anterior plating is a safe procedure that results in fusion. Neither significant subsidence of the cages nor significant loss of lordotic correction were seen. Trial registration Retrospectively registered. According to the Decision of the ethics committee, Jena on 25th of July 2018, that this study doesn’t need any registration. https://www.laek-thueringen.de/aerzte/ethikkommission/registrierung/.

scholarly journals Occurrence, Risk Factors, and Time Trends for Late Reoperations due to Degenerative Cervical Spine Disease: A Finnish National Register Study of 19 377 Patients Operated on Between 1999 and 2015

Neurosurgery ◽  
2020 ◽  
Author(s):  
Anna Kotkansalo ◽  
Ville Leinonen ◽  
Merja Korajoki ◽  
Katariina Korhonen ◽  
Jaakko Rinne ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cervical Spine ◽  
Time Trends ◽  
Patient Specific ◽  
Foraminal Stenosis ◽  
Primary Operation ◽  
Degenerative Cervical Spine ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

Abstract BACKGROUND Surgery for degenerative cervical spine disease has escalated since the 1990s. Fusion has become the mainstay of surgery despite concerns regarding adjacent segment degeneration. The patient-specific trends in reoperations have not been studied previously. OBJECTIVE To analyze the occurrence, risk factors, and trends in reoperations in a long-term follow-up of all the patients operated for degenerative cervical spine disease in Finland between 1999 and 2015. METHODS The patients were retrospectively identified from the Hospital Discharge Registry. Reoperations were traced individually; only reoperations occurring &gt;365 d after the primary operation were included. Time trends in reoperations and the risk factors were analyzed by regression analysis. RESULTS Of the 19 377 identified patients, 9.2% underwent a late reoperation at a median of 3.6 yr after the primary operation. The annual risk of reoperation was 2.4% at 2 yr, 6.6% at 5 yr, 11.1% at 10 yr, and 14.2% at 15 yr. Seventy-five percent of the late reoperations occurred within 6.5 yr of the primary operation. Foraminal stenosis, the anterior cervical decompression and fusion (ACDF) technique, male gender, weak opiate use, and young age were the most important risk factors for reoperation. There was no increase in the risk of reoperations over the follow-up period. CONCLUSION The risk of reoperation was stable between 1999 and 2015. The reoperation risk was highest during the first 6 postoperative years and then declined. Patients with foraminal stenosis had the highest risk of reoperation, especially when ACDF was performed.

Gadolinium DTPA-enhanced MRI of degenerative cervical spine disease*

1992 ◽  
Vol 2 (6) ◽  
Author(s):  
P. Schubeus ◽  
W. Sch�rner ◽  
B. Sander ◽  
T. Heim ◽  
N. Hosten ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Gadolinium Dtpa ◽  
Enhanced Mri ◽  
Degenerative Cervical Spine ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

Reoperation Rates After Surgery for Degenerative Cervical Spine Disease According to Different Surgical Procedures

Spine ◽  
2016 ◽  
Vol 41 (19) ◽  
pp. 1484-1492 ◽  
Author(s):  
Moon Soo Park ◽  
Young-Su Ju ◽  
Seong-Hwan Moon ◽  
Tae-Hwan Kim ◽  
Jae Keun Oh ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Surgical Procedures ◽  
Degenerative Cervical Spine ◽  
Reoperation Rates ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

Comparison of 3 Fusion Techniques in the Treatment of the Degenerative Cervical Spine Disease. Is Stand-Alone Autograft Really the “Gold Standard?”

Spine ◽  
2012 ◽  
Vol 37 (19) ◽  
pp. 1645-1651 ◽  
Author(s):  
Petr Vanek ◽  
Ondrej Bradac ◽  
Patricia DeLacy ◽  
Karel Saur ◽  
Tomas Belsan ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Gold Standard ◽  
Degenerative Cervical Spine ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

CERVICAL SPINE REOPERATION RATES AND HOSPITAL RESOURCE UTILIZATION AFTER INITIAL SURGERY FOR DEGENERATIVE CERVICAL SPINE DISEASE IN 12 338 PATIENTS IN WASHINGTON STATE

Neurosurgery ◽  
2009 ◽  
Vol 65 (6) ◽  
pp. 1011-1023 ◽  
Author(s):  
Joseph T. King ◽  
Khalid M. Abbed ◽  
Grahame C. Gould ◽  
Edward C. Benzel ◽  
Zoher Ghogawala
Keyword(s):  
Cervical Spine ◽  
Length Of Stay ◽  
Primary Diagnosis ◽  
Hospital Charges ◽  
Fusion Surgery ◽  
Cervical Spine Surgery ◽  
Degenerative Cervical Spine ◽  
Reoperation Rates ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease

Abstract OBJECTIVE Patients undergoing surgery for degenerative cervical spine disease may require future surgery for disease progression. We investigated factors related to the rate of additional cervical spine surgery, the associated length of stay, and hospital charges. METHODS The was a longitudinal retrospective cohort study using Washington state's 1998 to 2002 state inpatient databases and International Classification of Diseases–Ninth Revision–Clinical Modification (ICD-9) codes to analyze patients undergoing degenerative cervical spine surgery. Multivariate Poisson regression to identify patient and surgical factors associated with reoperation for degenerative cervical spine disease was used. Multivariate linear regressions to identify factors associated with length of stay and hospital charges adjusted for age, sex, year of surgery, primary diagnosis, payment type, discharge status, and comorbidities were also used. RESULTS A total of 12 338 patients underwent initial cervical spine surgeries from 1998 to 2002; the mean follow-up duration was 2.3 years, and 688 patients (5.6%) underwent a reoperation (2.5% per year). Higher reoperation rates were independently associated with younger patients (P &lt; 0.001) and a primary diagnosis of disc herniation with myelopathy (P = 0.011). Ventral surgery (P &lt; 0.001) and fusion (P &lt; 0.001) were both associated with lower rates of reoperation; however, a high correlation (Spearman's rho = 0.82; P &lt; 0.001) made it impossible to determine which factor was dominant. Longer length of stay was independently associated with nonventral approaches (+1.0 day; P &lt; 0.001) and fusion surgery (+0.8 day; P &lt; 0.001). Greater hospital charges were independently associated with nonventral approaches (+$2900; P &lt; 0.001) and fusion surgery (+$9600; P &lt; 0.001). CONCLUSION Patients undergoing surgery for degenerative cervical spine disease undergo reoperations at the rate of 2.5% per year. An initial ventral approach and/or fusion seem to be associated with lower reoperation rates. An initial nonventral approach and fusion were more expensive.

scholarly journals Combined Ventral and Dorsal Surgery for Degenerative Cervical Spine Disease

2009 ◽  
Vol 23 (2) ◽  
pp. 218-224
Author(s):  
Yuichi Takahashi ◽  
Kenki Nishida ◽  
Kouichi Ogawa ◽  
Kenichiro Hanabusa ◽  
Yasukazu Hijikata ◽  
...  
Keyword(s):  
Cervical Spine ◽  
Degenerative Cervical Spine ◽  
Spine Disease ◽  
Degenerative Cervical Spine Disease
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